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Home My WebLink AboutDibble, Blair Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 JUDITH T. TERRY TELEPHONF. TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD April 7, 1987 Blair Dibble 700 Bayview Avenue Southold, New York 11971 Re: Gold Spur Street Cutchogue, New York Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank or Cesspool System for which you applied. Please be advised that each owner of real property operating an on-site sewage disposal system, such as a septic tank or cesspool must, prior to such operation, possess in the name of the owner an Operation Permit for the system. The Operation Permit is issued by the Town Clerk's Office. The fee for an Operation Permit is ten dollars ($10. 00) for residential use and twenty-five dollars ($25.00) for non-residential. Please have the owner complete the enclosed Application for an Operation Permit and return it to this office along with the proper fee. For your general information I have enclosed an Informational Bulletin regarding the Scavenger Waste Laws adopted by the Southold Town Board. Should you have any questions pertaining to either permits or the Scavenger Waste Laws, please do not hesitate to contact this office. We will be glad to assist you in any way possible. Very truly hours, Judith T. Terry Southold Town Clerk Enclosures (3) JTT/Ijc ��i OFFICE OF THE 'TOWN CLERK S�FFO Town of Southold 0� CSG Judith -T. Terry, TownClerk Town Nall, 5305 Main Road P. 0. Box 1179 Southold, New li York 11971 Off`• �� Telephone (516) 76I�-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 143 Residential X Non-Residential Fee $ 1p.00 ��— Septic Cesspool X PERMIT ISSUED TO: NAME:i Blair Dibble ADDRESS: 700 Bayview Avenue Southold New York 11971 DESCRIPTI N OF PROPOSED CONSTRUCTION or ALTERATION New Single Family Dwelling LOCATION I'OF PROPOSED CONSTRUCTION or ALTERATION: ... OWNED OF PROPERTY: Blair Dibble OWNER MAILING ADDRESS: 700 Bayview AvenUe, Southold New York OWNER PROPERTY ADDRESS: Gold Spur Street Cutchogue, New York TAX MAP NO. : Section 95 Block 4 Lot 18.15 CROSS STREET: Horseshoe Drive BUILDING PERMIT NUMBER CROSS REFERENCE: ---------------- Judith T. Terry Southold Town Clerk DAT E : April 7, 1987 (TOWN SEAL) OFFICE OF THE TOWN CLERK _ Town of Southold Judith T. Terry, Town Clerk Application No. Town Hall, 53095 Main Road Construction P. 0. Box 1179 - -- Southold, New York 11971 Alteration Telephone Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $� DATE APPLICANT NAME: ( c✓ r ��c APPLICANT ADDRESS: 70o &luy e-tu five -So tti J k to y< [(q 7 SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRR�UCTI r R ALTERATION: OWNER OF PROPERTY: > 1t^ V,rJ�h OWNER MAILING ADDRESS: 70U & tAC �, 0 Yr ( l 1 7 OWNER PROPERTY ADDRESS: �,�,,� � TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Section QQS Block OLY Lot )?,Ir CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: „ C ignature of Applicant RECEIVED BY: Town Clerk's Office DATE: _ t\A 0 a 0 v°h0' + o . :rte • __ _ . :--- -�• �. a i V �6°a h �' � o J x\'1 s as�A, bah 6� \`A ' • \ a .� QK R-- 25.00 n�• / �y39 / �' K C y Go* s p� F SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES SURVEY FOR BLAIR J. DIBBLE a LORRAINE-R. DIBBLE FOR APPROVAL OF CONSTRUCTION OF LOT NO. 15 , "OREGON VIEW ESTATES Sing) Family Residetlre Oniy AT CUTCHOGUE tt DATE OCT. 16, 1984 D}ATE a$ �7 HS t1+' S b TOWN OF SOUTHOLD SCALE: I me = 50' SUFFOLK COUNTY, NEW YORK NO. 84 - 1004 *UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARA�XW Ml�a NEW YORK STATELATION OF EDUCATIONLASECTION 7209 OF THE USL U @` PANY OF N.Y. EXPIRES TWO YEARS FROM DATE OF APPROVAL :COPIES OF THIS SURVEY NOT BEARING THE LAND y SURVEVOR'S INKED SEAL OR EMBOSSED SEAL SMALL O NOT BE CONSIDERED TO BE A VALID TRUE COPYJIGUARANTEG TME PERSON-060 WHOM THE S INDICATED SU0PI 11VEY S*IIEPARUN REO Y 10 HEALTH DEPARTMENT-DATA FOR APPROtNII TO CONSTRUCT AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN-NEAREST WATUI •AIN Mt. :SOURCE OF WATER, PRIMTE X IC MENTAL AGENCY AND LENDING INSTITUTION LISTED N SUFE Co. TAX MAP OIfT�� SLCTION Q�MACK�.�LOT�B•�� HEREON,AND TO THE ASSIGNEES OF THE LENDING *THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE ^ OTHER THAN THOSE SHOWN M[REON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT M THE WATER SUPPLY AND SEMMGE DISPOGAL SYSTEM FOR THIS RESIDENCE OWNERS WILL CONFORM 10 THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *01 STANCES SHOWN HEREON FROM PROPERTY LINES TO EXISTING STRUCTURES ARE FOR A SPECIFIC �CAMT� SERVICES.� ""St AND ARE NOT TO BE USED TO ESTABLISH d�A I P �/ _ PROPERTY LIMES OR FOR THE ERECTION OF fENt[f ADDRESS L7 (1t Vle T1IL. ��svcy YOUNG & YOUNG �RHEAAD�wYOR"KE NOTE : ■ = MONUMENT 6 = STAKE SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AW.YOUNG,PROFESSIONAL ENGINEER SUFFOLK COUNTY ON APR.4 ,1975 AS FILE N0.6241 ANNDDEN LAND SURVEYOR N.Y.S.LICENSE N0.12845 _-__., HOWARD W,YQt1Nt3. LAND SIIRVFYAR